The Medicare Inpatient (Encounter) file contains Medicare Advantage plan paid records for inpatient hospital stays.
This file includes (variable highlights):
- Admission, discharge dates
- diagnosis (ICD diagnosis) codes
- procedure (ICD procedure) codes
- diagnostic related group (DRG) codes
- patient discharge status code
- organization NPI
- Part C/Medicare Advantage benefit package and contract number
- Revenue center codes, dates, unit counts
- No payment variables are available
- Encounter records submitted to CMS by September, 2022 for dates of service in CY 2020
Special considerations:
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Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter data may include records for some of these additional items and services provided under the plan.
